Provider Demographics
NPI:1700643145
Name:REYES DE LA PAZ, MELANY
Entity type:Individual
Prefix:
First Name:MELANY
Middle Name:
Last Name:REYES DE LA PAZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1533 NE 35TH ST
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33909-6438
Mailing Address - Country:US
Mailing Address - Phone:817-609-7318
Mailing Address - Fax:
Practice Address - Street 1:1533 NE 35TH ST
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33909-6438
Practice Address - Country:US
Practice Address - Phone:817-609-7318
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-04
Last Update Date:2025-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician